Quantity Limits

Safety is Our Priority

New drugs and new drug information come to the market at an astounding pace. Additionally, a record number of drugs have been taken off the market because of safety issues that were identified after marketing.

In order to help assure our members have access to safe, effective drug therapy and to protect against inappropriate use and waste, we require quantity limits on selected prescription medications.

Quantity Limits

For certain drugs, we limit the amount of the drug that we will cover. For example, we provide 30 tablets per 30-day supply for Januvia. The same quantity limits requirements apply to both home delivery and retail pharmacies.

For patients who require higher doses for medical purposes, an exception process is in place. Your doctor must complete the exception process demonstrating that you meet medical criteria. Information on the exception process is available by calling Customer Care toll-free at 1-877-883-9577, (TTY/TDD 1-800-421-1220) 8 a.m. to 8 p.m. Monday - Friday. From Oct. 1 to Mar. 31, representatives also are available from 8:00 a.m. - 8:00 p.m., 7 days a week.

Excellus BlueCross BlueShield contracts with the Federal Government and is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. .